Aldesleukin

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Key Terms: Corticosteroids, Intravenous line, Kilogram, Lymphatic system, Metastatic, Milligram, Toxicity.

Definition

Aldesleukin is interleukin, or specific kind of biological response modifier, that is used to treat metastatic renal cell carcinoma (a form of kidney cancer) and meta-static melanoma. Aldesleukin is also known as interleukin-2, IL-2 and the trademarked name Proleukin.

Purpose

When renal cell carcinoma and metastatic melanoma (cancer of the skin that arises in the pigmented cells of the skin or eyes) do not respond to other therapies, they are candidates for treatment with aldesleukin.

Description

Aldesleukin is a biological response modifier (BMR). It promotes the development of T cells, or the cells in the lymphatic system that can fight cancer cells in cell-to-cell interaction. The human body produces aldesleukin naturally.

For use in therapy, aldesleukin is manufactured in a laboratory setting, using biotechnology methods, or methods that combine biological mechanisms and tools from technology. In the instance of aldesleukin, the compound is made in large quantities by using recombinant DNA technology. The DNA, or hereditary material, that provides instructions for making aldesleukin, is put in bacterial cells under laboratory confinement. The cells then produce large quantities of the human compound that are harvested, purified, and used for treatment.

Treatment with aldesleukin is considered palliative, which means it provides comfort but does not produce a cure. In some cases, aldesleukin is used together with an anticancer drug.

Recommended Dosage

Standard treatment with aldesleukin is via an intravenous line. The standard dose is 0.037 milligrams per kilogram of body weight every eight hours. For renal cancer, up to 15 doses can be repeated over 7-10 days every 5–6 weeks. But because the aldesleukin has such severe side effects, lower doses are being tried. And delivery of aldesleukin via an inhaler, or a mechanical device that puts the compound into the air passages when a person breathes, is being used in the case of metastatic melanoma that has invaded the lungs.

Precautions

Side effects from aldesleukin are generally very severe. No one who already has a metastatic growth in the central nervous system should take the treatment because aldesleukin will incite, or aggravate, symptoms from the tumor.

Side Effects

Aldesleukin causes changes in the ways body fluids accumulate in the body that can lead to ascites and pleural effusions. Changes in personality are common due to the influence the drug has on the central nervous system. Among the most severe side effects is the possibility a patient will slip into a coma, or unconscious state. Other side effects may include alterations in liver function, skin reactions, such as rash, and infections may be severe and life threatening. Less serious, and almost always transient side effects, include flu-like symptoms, such as nausea and vomiting.

Interactions

Aldesleukin interacts with drugs that affect the central nervous system and it should not be taken with drugs that are used to modify moods or disposition (psychotropic agents). Many drugs, including those used to control blood pressure, heart beat and kidney function, increase the toxicity of aldesleukin and should not be taken in combination with it. Corticosteroids also interfere with the action of aldesleukin.

Physicians must be informed about every drug a patient is taking so interactions can be avoided.

—Diane M. Calabrese

(interleukin-2, IL-2), trade name: Proleukin; drug class: antineoplastic; action: enhancement of lymphocyte mitogenesis and stimulation of IL-2-dependent cell lines; uses: metastatic renal cell carcinoma in adults.

Brand names: Proleukin®

Español:
• Aldesleukina, Solución para inyección

Aldesleukin Solution for injection

What is this medicine?

ALDESLEUKIN, IL-2 is a chemotherapy drug. It is usually used for advanced renal cell cancer or for advanced melanoma. It is sometimes used for other cancers.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:
• blood problems
• extreme tiredness
• fever or infection
• heart, lung, kidney, or liver disease
• immune system problems
• mental disorders
• organ transplant
• seizures
• stomach problems
• thyroid problems
• an unusual or allergic reaction to aldesleukin, bacterial proteins, mannitol, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I use this medicine?

This medicine is for injection into a vein but can also be injected under the skin. It is given by a health care professional in a hospital or clinic setting.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
NOTE: This medicine is only for you. Do not share this medicine with others.

What may interact with this medicine?

• aminoglycosides
• contrast media
• interferon alfa
• medicines for cancer like doxorubicin, methotrexate, asparaginase, cisplatinum, dacarbazine, and tamoxifen
• medicines for depression, anxiety, or psychotic disturbances
• medicines for blood pressure like beta blockers
• medicines for pain including pentazocine, buprenorphine, butorphanol, nalbuphine, tramadol, and propoxyphene
• medicines for sleep
• NSAIDs, medicines for pain and inflammation, like ibuprofen or naproxen
• phenothiazines like chlorpromazine, mesoridazine, prochlorperazine, and thioridazine
• steroid medicines like prednisone or cortisone

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medicine?

Your condition will be monitored carefully while you are receiving this medicine.

Visit your doctor or health care professional for regular checks on your progress. You will need frequent blood checks.

Try to avoid people who are sick. If you get a cold or other infection while receiving this medicine, call your doctor or health care professional. Do not treat yourself. The medicine may decrease your body's ability to fight infections.

The medicine may make you feel generally unwell. This is not uncommon. Tell your doctor or health care professional about any side effects or problems you develop.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:
• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
• changes in vision
• chest pain, fast or irregular heartbeat
• confusion, agitation, anxiety, or hallucinations
• difficulty breathing, wheezing
• dizziness, fainting spells
• fever, chills, cough, or sore throat
• redness, blistering, peeling or loosening of the skin, including inside the mouth
• reduced urine output or dark yellow or brown urine
• unusual bleeding or bruising
• unusual swelling, especially of the face, feet, or ankles
• unusually weak or tired
• vomiting
• yellowing of eyes and skin

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):
• diarrhea
• drowsiness
• loss of appetite
• nausea
• sore mouth
• stomach pain

This list may not describe all possible side effects.

Where should I keep my medicine?

This drug is given in a hospital or clinic and will not be stored at home.

Last updated: 7/1/2002

Important Disclaimer: The drug information provided here is for educational purposes only. It is intended to supplement, not substitute for, the diagnosis, treatment and advice of a medical professional. This drug information does not cover all possible uses, precautions, side effects and interactions. It should not be construed to indicate that this or any drug is safe for you. Consult your medical professional for guidance before using any prescription or over the counter drugs.